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General NPI Number Information
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NPI Number | 1821897307
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Entity Type | Organization
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Legal Business Name | SOLA SMILE PLLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 8701 MENCHACA RD STE 200
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City | AUSTIN
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State | TX
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Zip | 78748-5383
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Country | US
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Telephone | 512-614-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 3106 FONTANA DR UNIT B
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City | AUSTIN
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State | TX
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Zip | 78704-6332
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Country | US
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Telephone | 214-663-5432
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. AUDREY SU
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Credential | DDS
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Telephone | 214-663-5432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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